Caregiver's Corner No. 2

In order to understand life after a stroke, at least for us, you need to understand about aphasia. Here is what the National Stroke Association says about aphasia.

APHASIA
Aphasia is an impairment of language the ability to use and comprehend words. It is a common problem for many stroke survivors. Having aphasia may make it hard to:

· Talk
· Understand what other people say
· Read
· Write
· Use numbers and do calculations

No two people experience aphasia the same way. Some people have different symptoms than others. Some have mild problems, while others experience more severe problems.

Stroke-related aphasia typically improves within the first weeks, and continued improvements occur for months and even years. Have patience, a positive attitude and the willingness to learn about aphasia and the resources available. It is important to remind yourself that recovery can continue years after the stroke.

The goal for people with aphasia is to improve their ability to communicate with other people. This is done by getting back some language skills and learning new ways of getting a message across when needed.

What can help:
· Join an aphasia support group to meet and learn from other stroke survivors with aphasia and their families.
· Keep in mind that some days will be better than others. Remember to rest, pace yourself and stay relaxed.
· Most people with aphasia benefit from therapy by a speech and language pathologist. Your doctor can refer you to the appropriate person for your needs.
· Be patient; most survivors need time to adjust to the major life changes brought about by the stroke before they can maximize their therapy.
· Remember that while aphasia can make communication difficult, it should not affect the ability to think clearly.
· Emotional responses such as anger, distress, depression, anxiety, low self-esteem and dependency are common; that’s why counseling is sometimes recommended.

SymptomsAccording to the Aphasia Handbook by the National Aphasia Association, someone may experience one or more of the following problems:

TALKING
· I find it difficult to talk at all.
· I struggle to get every word out.
· I miss small words, like to and of.
· I can't find the exact words I want.
· I talk a lot. But what I say is difficult to follow.
· I use strange words which sound foreign or nonsensical.
· I get stuck on certain words or phrases.
· I think I am talking perfectly well but I am not.

LISTENING AND UNDERSTANDING
I can hear, but:
· I have difficulty listening, and understanding what other people say.
· I have difficulty understanding some words.
· I have difficulty following conversations.
I can mostly follow what others say, but this gets difficult:
· In a crowded or noisy place.
· When I'm tired or anxious.
· If the other person talks too quickly.
· Or doesn't make it clear what the topic of conversation is.
· Or uses complicated words or long sentences.
· Or if several people are involved in the conversation.

READING
I can see, but:
· I find it difficult to understand what I try to read.
· I can read some words, but nothing too long or complicated.
· I can read most things, but get stuck when I have to take in details.

WRITING
· I can't spell.
· I find it hard to plan or organize what I want to write.
· I have difficulty making grammatical sentences.
· I can't write at all.
· I can write some letters of the word I want but not the whole word.

USING NUMBERS
· I can't use numbers and do calculations.
· I make mistakes with time, and money.
· I can't write checks or figure out my bills.
· I get stuck figuring out my change.

Suggestions for communicating with a person who has aphasia

· Treat the person with aphasia as an intelligent adult; aphasia does not typically affect thinking skills.
· Speak simply, clearly and slowly.
· Be sure the person with aphasia understood you.
· Use props to make conversation easier (photos, maps).
· Draw or write things down on paper.
· Be patient. Take one idea at a time.
· Try different ways to get your message across.

If you got this far, it should help as we go along on this journey. What I tell people about aphasia is this--imagine you are driving down the road one day, a road you travel on every day and one morning you go to drive down that road and you discover there was an earthquake overnight. The road may be passable, but there will be many obstacles in your way. You will get to your destination eventually, if you don't lose your way, but it will take time and a lot of effort.

Another way to think about this is to imagine file drawers in your office. This may be a little old fashioned since many people have all their files stored electronically, but stick with me for a second. In these drawers are thousands of files that you have gathered over the years. All the files are properly labeled and filed in a system you have developed over these same years. One morning you come to the office and discover that someone has ransacked your office and scattered all your files all over the place. You need to find the file labeled CAN OPENER. You know that file is in there but finding it may take a while. In the process of looking for the file, you find one labeled PLIERS. In your frustration, you decide that this file will do the trick. It's not quite what you are looking for, but it is a tool after all, just like the CAN OPENER is a tool, so maybe it will work for your purposes, at least in the short run.

That is what happened to Carrie one day. She took a CAN OPENER out of the dish drainer and asked, "What do you want me to do with this pair of PLIERS?" She knew it was a tool, but just couldn't find the name of the tool. I told her that what she had in her hand was not a pair of pliers and asked her, "What do you do with that?" "Open cans", she replied. "So what would you call that then?" "A CAN OPENER" she said triumphantly!

And that is how it goes with aphasia. More on the subject as we go along...